Orthesis comprising an adjustable range of movement

ABSTRACT

The invention relates to an orthesis comprising a first bar ( 2 ) and a second bar ( 3 ) joined to the latter in an articulated manner, in addition to at least one click-stop dial ( 14,15 ), for adjusting the pivoting-range stops in an extensional or flexional direction. The invention is also provided with a fixing device, which comprises a locking disc ( 16 ) that is mounted in a rotationally fixed manner in relation to the first bar ( 2 ) and can be displaced in the direction of the pivoting axis ( 102 ), for blocking the click-stop dial ( 14, 15 ). The locking disc ( 16 ) can be moved by being displaced between a position that blocks the click-stop dial ( 14, 15 ) by radial impingement, in which the locking disc ( 16 ) engages with the click-stop dial ( 14, 15 ) in a locking positive fit and a release position, in which the locking disc ( 16 ) is disengaged from said click-stop dial ( 14, 15 ).

The invention relates to an orthesis, for example an elbow orthesis,particularly for reduction of extension and/or flexion deficits, inaccordance with the preamble of claim 1.

Joint capsules and/or connective tissue, in particular, often have anextension deficit and/or flexion deficit after, for example, ligamentoperations, accidents, inflammation, etc. This means that a distal bodypart, for example a forearm, can no longer be brought completely to itsnormal extension or flexion position in relation to a proximal bodypart, for example an upper arm.

As is known, ortheses are used to guide such joints, particularly duringmovement. Moreover, the orthesis is intended to limit the movement ofthe joint in the extension and/or flexion direction in such a way thatinjuries caused by excessive strain are ruled out.

Moreover, in order to stretch out the contractions and shrinkages in thearea of the joint, use is also made of what are referred to as quengeldevices, i.e. ortheses which are pretensioned by a spring and whichsupport the movement of the body part as far as the desired extension orflexion limit.

In ortheses, the extension and flexion limit stop must be able to beadjusted within wide limits in order to satisfy the individualrequirements of the patient.

Moreover, it is desirable to permit straightforward and rapidadjustability of the pivot range limits so that, with increasingmobilization of the joint, the pivot range limits can be suitablyreadjusted with ease and speed.

To limit the pivot range, known ortheses used for stretching have limitstop pins which can be inserted into different bores arranged around thepivot axis. A disadvantage of these, however, is that adjustment of theextension and flexion limit stop is possible only in fairly largeincrements, for example in 15° increments, and the pivot range limitsfor this reason often cannot be adjusted with sufficient precision.

U.S. Pat. No. 5,873,847 discloses an orthesis in which there are noinsertable limit stop pins, but instead two click-stop dials arrangedone behind the other for adjusting the pivot range limits in theextension direction and flexion direction. To block these click-stopdials, a fixing device is provided in the form of two pressure plateswhich can be clamped together by means of a screw and in this way clampthe click-stop dials lying between them. A disadvantage of this,however, is that in order to adjust the pivot range limits, a tool isneeded for releasing the fixing device and then for clamping it togetheragain. Such a tool is often not immediately to hand when needed. Anotherproblem is that the click-stop dials have to be clamped togetherrelatively firmly in order to rule out the possibility of undesiredrotation of the limit stops. This requires that a certain force beapplied when tightening and releasing the fixing device. If the fixingscrew is not sufficiently tightened, this can lead to undesired rotationof the click-stop dials and thus to an overextension of the muscles,ligaments or tendons.

Therefore, it is an object of the invention to make available anorthesis of the type mentioned at the outset, with which the flexionand/or extension limit stop can be adjusted and blocked in astraightforward, rapid, precise and reliable way.

According to the invention, this object is achieved by the features ofclaim 1. Advantageous embodiments of the invention are described in thefurther claims.

In the orthesis according to the invention, the fixing device has alocking disk which is displaceable in the direction of the pivot axisand is mounted in a rotationally fixed manner in relation to the firstbar. This locking disk can be moved, by being displaced, between ablocking position, in which the locking disk engages radially over theclick-stop dial and is in locked form-fit engagement with saidclick-stop dial, and a release position, in which the locking disk isdisengaged from the click-stop dial.

Thus, in the orthesis according to the invention, the locking of the atleast one click-stop dial is effected by means of an axiallydisplaceable locking disk which, in the engagement position, is inform-fit engagement with the click-stop dial and, in the releaseposition, is no longer in contact with the click-stop dial. Axiallydisplaceable in this context means that the locking disk is displaceablein the direction of its own axis of rotation and thus in the directionof the pivot axis of the bar hinge.

By virtue of the fact that the rotationally fixed locking disk is nolonger in engagement with the click-stop dial via a force fit, butinstead via a form fit, undesired rotation of the click-stop dial isexcluded. The form-fit connection is expediently obtained by means ofthe click-stop dial having an outer toothing, and the locking diskhaving an inner toothing which can be moved into and out of meshingengagement with the outer toothing of the click-stop dial.

The displacement of the locking disk in the axial direction isexpediently effected by means of a rotation part, for example arotatable cover part, which has an internal thread and is in engagementwith an external thread of the locking disk. When the rotation part ismoved, the locking disk moves in the manner of a spindle in the axialdirection and can thus be brought into and out of engagement with theclick-stop dial. When the locking disk is disengaged from the click-stopdial, said click-stop dial can be brought to the desired rotationposition until the associated pivot range stop is in the desired angleposition. Moreover, by turning the rotation part in the oppositedirection, the locking disk is brought back into engagement with theclick-stop dial and thus blocks the latter.

The extension and/or flexion limit stop can thus be adjusted and blockedin a very straightforward, rapid, precise and reliable way, and withoutusing a tool.

An example of the invention is explained in more detail below withreference to the drawings, in which:

FIG. 1 shows a perspective view of the orthesis according to theinvention,

FIG. 2 shows an exploded view of the individual parts of the orthesisfrom FIG. 1,

FIG. 3 shows a longitudinal section through the bar hinge of theorthesis from FIG. 1,

FIGS. 4A and 4B show an oblique view of a housing from above and frombelow, respectively,

FIG. 5 shows a longitudinal section through a rotation part,

FIG. 6 shows a plan view of a cover plate,

FIGS. 7A and 7B show a plan view and side view, respectively, of alocking disk,

FIG. 8 shows a perspective view of a click-stop dial,

FIG. 9 shows a longitudinal section through the housing, with insertedrotation block of a dead-point adjustment mechanism,

FIG. 10 shows a view according to FIG. 9, also with insertion of ablocking pin with compression spring and an eccentric part,

FIG. 11 shows a perspective view of the rotation block,

FIGS. 12A to 12C show a longitudinal section through the housing withtwo click-stop dials and the fixing device for blocking the click-stopdials, with the locking disk situated in the locking position and in twodifferent release positions, and

FIG. 13 shows a perspective view of a portion of the second bar withfitted limit stop element.

FIG. 1 depicts an orthesis 1 for reducing extension and/or flexiondeficits of elbow joints, with a first bar 2 to be fastened to the upperarm, and with a second bar 3 which is to be fastened to the forearm andwhich is connected to the first bar 2 in an articulated manner via a barhinge 4. They are fastened to the upper arm and forearm, respectively,in a known manner by means of half-shells 5, which are arranged on thefirst bar 2 and second bar 3, and via tapes or straps 6 which are woundround the upper arm and forearm.

The orthesis shown is designed to be applied only on one side of thejoint in question. However, it is also conceivable for a joint to beprovided with two such ortheses, which are then applied on differentsides of the joint.

Moreover, the orthesis shown has a spring force mechanism with a springhousing 7, in which a compression spring (not visible in FIG. 1) isarranged, and with a push rod 8. By means of the push rod 8, the forceof the compression spring is transmitted from the first bar 2 to thesecond bar 3 in such a way that a pivoting force is generated betweenthe two bars 2, 3 both in the extension direction and in the flexiondirection. It is therefore a stretching device acting at both ends.Since a spring force mechanism of this kind is already known, it isexplained only insofar as is necessary for an understanding of theinvention.

The orthesis illustrated permits simple and precise adjustment, withouta tool, of the pivot range limits in the extension direction and flexiondirection by means of two adjustment pins 9, 10, and also simpleadjustment of a dead point starting from which the spring forcemechanism acts in the flexion direction and extension direction, byturning a control knob 11.

The individual components of this orthesis are explained in detail belowwith reference to FIG. 2. The pivot axis is indicated there by 102. Thecore of the bar hinge 4, which connects the two bars 2, 3 to oneanother, is a housing 12 (shown in more detail in FIGS. 4A and 4B) whichis fixedly screwed onto the first bar 2 in an edge area. Arranged on thefront face of the housing 12 in FIG. 2 there are: an elastomer ring 13,a first click-stop dial 14 for adjusting the extension limit stop, asecond click-stop dial 15 for adjusting the flexion limit stop, alocking disk 16 which surrounds the click-stop dials 14, 15, anelastomer ring 17, a rotation part 18 (shown in more detail in FIG. 5),and a cover plate 19.

Arranged on the rear face of the housing 12 in FIG. 2 there are: acentral rotation block 20 for adjusting the dead point of the springforce mechanism, a catch 21 arranged axially displaceably in therotation block 20, the second bar 3, onto which a limit stop device 22is fixedly screwed, the first bar 2, and a retaining plate 23.

The spring housing 7 containing the compression spring 24 is fixedlyscrewed onto the second bar 3. The compression spring 24 bears with itsfront end on a pressure cylinder 25 which is connected in an articulatedmanner to the push rod 8. At the opposite end, the push rod 8 isconnected in an articulated manner to a radially projecting arm 26 ofthe central rotation block 20. The thrust force of the compressionspring 24 is thus transmitted constantly to the arm 26 by the push rod8.

At the rear end, the compression spring 8 is supported on aspring-tensioning plug 27 which is designed as a spindle nut withinternal thread. A spring-tensioning shaft 28, which represents aspindle, is screwed into this spring-tensioning plug 27. Thespring-tensioning shaft 28 can be set in rotation via a crank 29, acrankshaft 30 and gear wheels 31, by which means the spring-tensioningplug 27 is moved in the axial direction, so that the pretensioning forceof the compression spring 24 can be adjusted. The gear wheels 31 aremounted in a gear housing 32.

FIG. 2 also shows the details of the control knob 11 with which aneccentric part 33 can be turned. As will be explained in more detaillater, the eccentric part 33 is used for locking and releasing aradially arranged blocking pin 34, which is mounted with possibility oflongitudinal displacement in the arm 26 of the rotation block 20.

The individual parts and their functions will now be described in detailwith reference to FIGS. 3 to 13.

The housing 12 is shown from the front in FIG. 4A and from the rear inFIG. 4B. The housing 12 has a plane middle wall 35 which is interruptedby a longitudinal slit 36 in the shape of an arc of a circle. Thelongitudinal slit 36 extends over about 180°. Extending upward andperpendicularly from the middle wall 35 there is a circumferential wall38 which is interrupted by slits 37 distributed uniformly about thecircumference and which thus forms individual fingers. The width of theslits 37 corresponds approximately to the width of the fingers.Moreover, protruding above the middle wall 35 there is a central sleeveportion 39 which serves as a rotation bearing for the click-stop dials14, 15 shown in FIG. 8. Middle wall 35 and sleeve portion 39 have acentral bore 40 running continuously through them.

As can be seen from FIG. 4B, a circumferential wall 41 extends above therear face of the middle wall 35. The height of the circumferential wall41 is higher in a first circumferential portion 42 than in a secondcircumferential portion 43. Situated in the first circumferentialportion 42 there are several axially oriented threaded bores 44,allowing the first bar 2, which bears on the first circumferentialportion 42, to be screwed tight by means of screws 45 (FIG. 3). Theheight of the second circumferential portion 43 is reduced compared tothe first circumferential portion 42, along a circumferential length ofabout 200°, so as to create a corresponding free space for the first bar2 and the push rod 8 which extend radially beyond the secondcircumferential portion 43. Provided in the second circumferentialportion 43 there are also a plurality of radial blocking bores 46 whichare spaced apart uniformly in the circumferential direction and intowhich the blocking pin 34 of the central rotation block 20 can beintroduced, by which means the rotation position of the rotation block20 relative to the housing 12 is blocked. The rotation position of therotation block 20, and thus that of the coupling point 47 (FIG. 2) ofthe push rod 8 on the arm 26, can thus be adjusted by means of therotation block 20, with the blocking pin 34 drawn back, first beingturned to the desired rotation position, whereupon the blocking pin 34is latched in the desired blocking bore 46. This procedure is describedin more detail below.

As can be seen from FIG. 3, the first elastomer ring 13, closelysurrounding the central sleeve portion 39, sits on the plane middle wall35 of the housing 12. The first click-stop dial 14 sits on the firstelastomer ring 13, followed by the second click-stop dial 15 and theelastomer ring 17.

These click-stop dials 14, 15 are of largely identical design, so thatin FIG. 8 only one of these click-stop dials 14, 15 is shown. Theclick-stop dials 14, 15 are circular and have a central through-opening49, so that they can be fitted with slight play onto the central sleeveportion 39 of the housing 12. The central sleeve portion 39 thus forms arotation bearing for the click-stop dials 14, 15. Moreover, theclick-stop dials 14, 15 can also move axially slightly, as far as ispermitted by the elastomer rings 13, 17 between which they are clampedand which are made of relatively soft material.

On their outer circumference, the click-stop dials 14, 15 have arelatively fine outer toothing 50, which is shown diagrammatically inFIG. 8. Between the outer circumference and the through-opening 49, acontinuous longitudinal slit 51 in the shape of an arc of a circleextends over an angle range of approximately 200°. The two click-stopdials 14, 15 are mounted in such a way that the two longitudinal slits51 can at least for the most part be made congruent, and these in turnlie over the slit 36 of the housing 12. In this way, a limit stop pin 52shown in FIG. 3, and which is connected fixedly to the second bar 3 viaa base part 53 and screws 54, can extend upward through the longitudinalslits 36, 51 from below and move along these. Since the click-stop dials14, 15 are blocked via the outer toothings 50 in a rotationally fixedmanner relative to the housing 12 and thus relative to the first bar 2,the limit stop pin 52 can move inside the longitudinal slits 36, 51until it has arrived at the end of the longitudinal slits 51 and eitherstrikes against the limit stop 55 or against the opposite limit stop 56.It is thus evident that the position of the pivot range limits dependson the position of the limit stops 55, 56 relative to the housing 12and, consequently, to the first bar 2, and that, by independent turningof the click-stop dials 14, 15 relative to the housing 12, the pivotrange limits in the flexion direction and extension direction can beadjusted independently of one another.

In order to be able to rotate the click-stop dials 14, 15 to the desiredrotation position after they have been unlocked (in a manner which isdescribed in more detail below), each click-stop dial 14, 15 has, as canalso be seen from FIG. 3, an adjustment pin 57, 58 which protrudesupward through a longitudinal slit 59 shaped as an arc of a circle inthe cover plate 19 (FIG. 6) and projects slightly upward over the coverplate 19, so that the adjustment pins 57, 58 can be moved with thefingers. Along this longitudinal slit 59, a suitable scale 60 is set outon the cover plate 19 so as to make it possible to read off the positionof the limit stops 55, 56 and thus the pivot range limits in the flexiondirection and extension direction.

The click-stop dials 14, 15 are locked in the desired rotation positionvia the locking disk 16, which is shown in more detail in FIGS. 7A and7B. The locking disk 16 is of annular design and has a clear internaldiameter corresponding to the external diameter of the click-stop dials14, 15. On the inner circumferential wall, the locking disk 16 has aninner toothing 61 which can be brought into engagement with the outertoothing 50 of the click-stop dials 14, 15. Moreover, the locking disk16 has radial projections 62 which are distributed uniformly about itsouter circumference and whose length (in the circumferential direction)corresponds to the width of the slits 37 in the circumferential wall 38of the housing 12. When the locking disk 16 is fitted in the housing 12,the radial projections 62 extend through the slits 37 of the housing 12,so that the locking disk is received in the housing 12 in a manner fixedin terms of rotation, but axially displaceably. The external diameter ofthe radial projections 62 is also slightly greater than the externaldiameter of the circumferential wall 38 of the housing 12, so that theradial projections 62 extend radially outward slightly beyond thecircumferential wall 38.

The locking disk 16 can be displaced axially relative to the housing 12by means of the rotation part 18. For this purpose, the radialprojections 62 have an external thread 63 which is in engagement with aninternal thread 64 (FIG. 5) of the rotation part 18. The substantiallysleeve-shaped rotation part 18 forms the radial outer jacket of the barhinge 4 which covers the upper part of the housing 12, including thecircumferential wall 41 in which the blocking bores 46 are located. Therotation part 18 is not axially displaceable, but is fitted rotatably onthe housing 12. For this purpose, the rotation part 18 has, in its lowerthird, a radially inwardly projecting shoulder 65 which rests on an edgeprojection 66 of the housing 12 (FIG. 3) and fixes the rotation part 18axially toward the bottom. An axial displacement of the rotation part 18toward the top is prevented by a radially inwardly projecting shoulder67 which is located at the upper end of the rotation part 18 and overwhich the edge of the cover plate 19 engages.

As can also be seen from FIG. 3, an axial free space 68 is presentbetween the plane middle wall 35 and the first click-stop dial 14,because of the elastomer ring 13 lying between them. In the same way, anaxial free space 69 is present between the second click-stop dial 15 andthe cover plate 19, because of the elastomer ring 17 lying between them.The height of the free spaces 68, 69 is slightly greater than thethickness of the click-stop dial 14, 15. Because they have the sameheight, the elastomer rings 13, 17 hold the click-stop dials 14, 15,when viewed in the axial direction, in the center between the middlewall 35 and the cover plate 19.

The locking disk 16 forms, together with the rotation part 18, a fixingdevice for releasing and for blocking the click-stop dials 14, 15. Thelocking disk 16, which has the same thickness as the two click-stopdials 14, 15 taken together, can be moved up or down in the manner of aspindle by turning the rotation part 18, as is shown in FIGS. 12A to12C. In FIG. 12A, the locking disk 16 is situated at the same height asthe two click-stop dials 14, 15. Both click-stop dials 14, 15 aretherefore in engagement with the inner toothing 61 of the locking disk16 and a blocked by the latter in terms of rotation. When the rotationpart 18 is turned in a defined direction, the locking disk 16 can bedisplaced upward until the lower click-stop dial 14 is disengaged fromthe locking disk 16. This state is shown in FIG. 12B. The lowerclick-stop dial 14 can therefore be brought by hand to the desiredrotation position by means of the adjustment pin 57, for example inorder to adjust the extension limit stop. If the rotation ring 18 isthen turned in the opposite direction, the locking disk 16 can be moveddownward until the upper click-stop dial 15 is disengaged from thelocking disk 16. This state is shown in FIG. 12C. The upper click-stopdial 15 can now be turned to the desired position by means of theadjustment pin 58, for example in order to adjust the flexion limitstop. When both click-stop dials 14, 15 have been correctly adjusted,the rotation part 18 is screwed back again until the locking disk 16locks both click-stop dials 14, 15 (FIG. 12A).

Since, upon axial movement of the locking disk 16 from the positionshown in FIG. 12B or 12C to the middle position shown in FIG. 12A, itcan happen that the inner toothing 61 of the locking disk 16 does notmesh properly with the outer toothing 50 of the click-stop dials 14, 15,and instead thread teeth strike against thread teeth, the elastomerrings 13, 17 are made relatively soft and permit yielding of theclick-stop dials 14, 15 in the axial direction. In this way, mutualengagement of the toothings is made easier.

The cover plate 19 is shown in FIG. 6. As can be seen, the top facebears the indications “Flexion adjustment”, “Stop” and “Extensionadjustment”. These indications show in which direction the rotation part18 has to be turned in order to free the click-stop dial for the flexionlimit stop or the click-stop dial for the extension limit stop. In the“Stop” position, both click-stop dials 14, 15 are locked.

Referring to FIGS. 9 to 11, the dead-point adjustment mechanism is nowdescribed in more detail, with which mechanism it is possible to adjustthe dead point starting from which the direction of action of the springforce mechanism is reversed from flexion to extension, or vice versa.For this purpose, the central rotation block 20, which is shown indetail in FIG. 11, has a cylindrical portion 70 which is fitted into thecentral bore 40 of the housing 12 and is mounted so as to be able torotate therein. Adjoining the cylindrical portion 70 there is acylindrical portion 72 of greater diameter, on which the arm 26 isintegrally formed in such a way that it extends radially away from theportion 72. A circumferential radial projection 73 adjoins thecylindrical portion 72. This radial projection 73 serves as a bearingsurface for the circular end portion 74 of the second bar 3. Adjoiningthe radial projection 73 there is a cylindrical portion 75 (FIG. 11)which serves as a radial bearing for the second bar 3. Axial threadedbores 76 are provided in the cylindrical portion 75 in order to be ableto screw tight the retaining plate 23 by means of screws 77 indicated inFIG. 3.

As can be seen from FIGS. 9 and 10, a central axial bore 78 is locatedin the cylindrical portion 70 of the rotation block 20, in which acylindrical portion 79 of the eccentric part 33 is rotatably mounted.The bore 78 opens into a circular pocket 80 of greater diameter which isarranged eccentrically with respect to the bore 78. The pocket 80 isused to receive an eccentric cylinder portion 81 of the eccentric part33, so that the latter cannot turn when the eccentric cylinder portion81 lies in the pocket 80. This position is shown in FIG. 10.

The pocket 80 is adjoined by an axial, central bore 82 of greaterdiameter. The diameter of this bore 82 is such that the eccentric part33 can be turned in any desired way when it has been displaced upwardfrom the position shown in FIG. 10 in the axial direction, i.e. in thedirection of the arrow 91, and so far that the eccentric cylinderportion 81 is situated above the pocket 80.

Directly above the pocket 80, as can be seen from FIG. 9, a radial bore83 extends through the whole arm 26 and is used for receiving theblocking pin 34 and a compression spring 84 (FIG. 10). In an outer endportion 85, the bore 83 has a smaller diameter, so that a shoulder 86 isformed on which the outer end of the compression spring 84 is supported.The blocking pin 34 has a shaft 87 and a head 88 of greater diameter onwhich the opposite end of the compression spring 84 is supported. Thelength of the blocking pin 34 is also such that its outer end protrudesbeyond the arm 26 and into one of the blocking bores 46 when theopposite end of the head 88 is flush with the wall of the bore 82. When,in this state which is shown in FIG. 10, the eccentric cylinder portion81 of the eccentric part 33 is situated inside the pocket 80, theblocking pin 34 cannot move back into the bore 82, because it strikesagainst the eccentric cylinder portion 81. The blocking pin 34 is thuslocked in a manner preventing a rotation movement of the rotation block20 relative to the housing 12. The coupling point 47 (FIG. 2), which isformed by an axial bore 89 in the arm 26 (FIG. 10) and by a hinge pin 90(FIG. 3) fastened in the push rod 8 and engaging in the bore 89, is thusfixed relative to the housing 12.

In order to adjust the coupling point 47 and thus the dead point of thespring force mechanism, the eccentric part 33 is displaced in thedirection of the arrow 91 (FIG. 10) counter to the force of acompression spring 92 (FIG. 3) by means of turning the control knob 11until the eccentric cylinder portion (81) lies outside the pocket 80.The eccentric part 33 can then be turned through 180° by means of thecontrol knob 11, which is connected to the eccentric part 33 in arotationally fixed manner via a square part 93, as a result of which theblocking pin 34 moves back into the bore 82 under the force of thecompression spring 84, and the opposite end of the blocking pin 34 canemerge from the blocking bore 36. The rotation block 20 can now berotated farther to another desired blocking bore 46, whereupon theblocking pin 34 is brought back into the locking engagement position bymeans of turning the eccentric part 33 back.

With the blocking pin 33 unlocked, the rotation block 20 is rotated tothe desired position relative to the housing 12 by means of the secondbar 3, which can be connected in a rotationally fixed manner to therotation block 20 via the catch 21 shown in FIGS. 2 and 3. The catch 21has a hub-shaped middle part 94, from which two wings 95 extend inopposite directions.

In normal operation of the orthesis, i.e. when the eccentric part 33 inFIG. 10 is at the lowest position shown, the hub-shaped middle part 94of the catch 21 is arranged at the lowest possible position inside thebore 82, the wings 95 lying deep in radial grooves 96 of the centralrotation block 20 (FIG. 11). In this state, the wings 95 do not extendupward past the radial projection 73, so that the second bar 3 can turnabout the cylindrical portion 75 of the rotation block 20. However, ifthe eccentric part 33 is pushed upward in order to unlock the blockingpin 34 (see arrow 91 in FIG. 10), the catch 21 is thus also pushedupward, as a result of which the wings 95 can be pushed axially into thearea of the cylindrical portion 75 and into lateral grooves 97 (FIG. 13)which extend radially outward from the central bearing bore 98 of thesecond bar 3. In this way, the second bar 3 is connected in arotationally fixed manner to the rotation block 20, so that the lattercan be turned in the desired manner by means of the second bar 3 whenthe blocking pin 34 is unlocked.

As can be seen from FIG. 3, the hub-shaped middle part 94 of the catch21 serves to support the compression spring 92. The opposite end of thecompression spring 92 is supported on the outer, central retaining plate23. If the eccentric part 33 is turned in such a way that the eccentriccylinder portion 81 can move back into the pocket 80 of the rotationblock 20, the compression spring 92 presses the catch 21 together withthe eccentric part 33 back into the position shown in FIG. 3. In thisway, the wings 95 of the catch 21 disengage from the lateral grooves 97of the second bar 3, so that the latter can be pivoted again within theset pivot range limits about the rotation block 20 and thus relative tothe first bar 2.

To minimize the friction between the circular end part of the first bar2 and the circular end part of the second bar 3, a shim element 99 isinserted between these end parts, as can be seen from FIG. 3.

In the illustrative embodiment shown, the internal thread 64 of therotation part 18 (FIG. 5) is arranged, for production engineeringreasons, on a separate thread ring 100 which is connected by means of asuitable adhesive to a jacket 101 of the rotation part 18.Alternatively, however, it is also entirely possible to form theinternal thread 64 directly on the jacket 101.

The invention has been described taking the example of an elboworthesis, but it can be used for other ortheses too, for example kneeortheses.

1. An orthesis with a first bar which can be fastened to a first bodypart, a second bar which can be fastened to a second body part, a barhinge for pivotable connection of said first and second bars, at leastone click-stop dial which is rotatable about a pivot axis, can beblocked in different rotation positions and is used for adjusting apivot range limit, and a fixing device for blocking said at least oneclick-stop dials, characterized in that said fixing device has a lockingdisk which is displaceable in the direction of said pivot axis, ismounted in a rotationally fixed summer manner in relation to said firstbar and can be moved, by being displaced between a blocking position, inwhich said locking disk engages radially over said at least oneclick-stop dial and is in locked form-fit engagement with said at leastone click-stop dial, and a release position, in which said locking diskis disengaged from said at least one click-stop dial.
 2. The orthesis asclaimed in claim 1, characterized in that said at least one click-stopdial has an outer toothing, and said locking disk has an inner toothingwhich can be moved into and out of meshing engagement with said outertoothing of said at least one click-stop dial.
 3. The orthesis asclaimed in claim 1, characterized in that said locking disk has a threadand can be moved in the manner of a spindle via said thread.
 4. Theorthesis as claimed in claim 1, characterized in that said locking diskhas a thread on its radial outer circumferential surface, and in thatsaid fixing device has an axially fixed rotation part which radiallysurrounds said locking disk and has an internal thread, which rotationpart engages with said thread said of said locking disk and, whenrotated, causes an axial displacement of said locking disk.
 5. Theorthesis as claimed in claim 1, characterized in that two saidclick-stop dials are provided for adjusting said pivot range limits inthe extension direction and flexion direction, said click-stop dialsbeing arranged parallel and next to one another and being able to beblocked simultaneously by the same said locking disk.
 6. The orthesis asclaimed in claim 5, characterized in that said fixing device is designedin such a way that, by displacing said locking disk in one direction,said extension click stop dial is released, and, by displacing saidlocking disk in the opposite direction, said flexion click-stop dial isreleased.
 7. The orthesis as claimed in claim 1, characterized in thatsaid bar hinge has a housing fixedly connected to said first bar andwith a circumferential wall partially surrounding said locking disk, inthat the said locking disk has radial projections, and in thatperipheral wall is provided with slits through which said radialprojections are guided in order to prevent rotation of said lockingdisk.
 8. The orthesis as claimed in claim 7, characterized in that saidhousing has a central sleeve portion designed as a rotation bearing forsaid at least one click-stop dial, in that a spring force mechanism isprovided in order to pretension said second bar relative to said firstbar both in the extension direction and in the flexion direction, and inthat a dead-point adjustment device for said spring force mechanism ismounted rotatably inside said sleeve portion.
 9. The orthesis as claimedin claim 8, characterized in that said dead-point adjustment mechanismcomprises a rotation block in which a blocking pin is displaceablyguided transversely with respect to said pivot axis, in that saidhousing has a plurality of radial blocking bores which are spaced apartin the circumferential direction of said housing, and in that aneccentric part is mounted rotatably inside said rotation block in orderto keep said blocking pin in engagement with a blocking bore or topermit removal of said blocking pin from said blocking bore.
 10. Theorthesis as claimed in claim 9, characterized in that said rotationblock of said dead-point adjustment mechanism is designed as a rotationbearing for said second bar.